Are Drugs Worsening My Nocturia?

Dr. Hunter Wessells

I have been taking Flomax for several weeks but my problem with excessive night time urination has increased. I thought Flomax was supposed to decrease this problem! Now, I have to get up five or six times a night when it used to be about three. Is Flomax the problem?

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Nocturia, or frequent nighttime urination, is a common problem for men. It is one of the lower urinary tract symptoms attributed to benign prostatic enlargement. Flomax, the medication you were prescribed, is designed to improve lower urinary tract symptoms caused by prostatic enlargement. The medicine works by relaxing the tone of the muscle at the bladder neck and prostate. Usually symptom improvements occur within the first few weeks of therapy. The fact that your nocturia seems to be worsening may indicate that the symptoms are being caused by something other than a prostatic enlargement. Nocturia may also caused by excessive nighttime fluid intake, redistribution of fluid from the body spaces into the vascular space thus increasing nighttime urine output, or the loss of nighttime internal hormone release that normally suppresses nighttime urine output. Most men with lower urinary tract symptoms due to benign prostatic enlargement are treated empirically, without extensive testing. However, when symptoms worsen or do not respond appropriately to medication, other tests may be indicated. Of course lower urinary tract symptoms can come from a variety of sources, including urinary tract infection, bladder stones, malignant and pre-malignant masses in the bladder, as well as neurological causes. Furthermore, the total symptom picture, including daytime frequency, force of urinary stream, urinary retention, and other features need to be considered.

I suggest that you be evaluated, or reevaluated, by a urologist in order to differentiate benign prostatic enlargement from other causes of lower urinary tract symptoms.

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